Healthcare Provider Details

I. General information

NPI: 1760877823
Provider Name (Legal Business Name): KAYLA BREANNE STARLING KEBBEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2015
Last Update Date: 02/01/2024
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE
ATLANTA GA
30308-2212
US

IV. Provider business mailing address

2450 HOLCOMBE BLVD STE NB-34L
HOUSTON TX
77021-2039
US

V. Phone/Fax

Practice location:
  • Phone: 404-686-4411
  • Fax:
Mailing address:
  • Phone: 832-828-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR8028
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number46992
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number85899
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: